My first piece of advice for pain management is that whatever you use, take control of your own pain management as soon as you can.  The nurses in hospital are really tight with drugs.  After the epidural was removed I was on two paracetamol at eight hour intervals and two tramadol at eight hour intervals – so two tables every four hours (and I was gutted whenever I was woken up by the pain before my four hours were up, because I had to lie there, watching the clock, until I could have more pain killers and get back to sleep.)

One time I actually managed to distract myself for six hours and when I asked for my drugs they said I had to wait for the next lot – another two hours.  Well, I never missed them after that, and unfortunately when I left the hospital I carried on the regime – taking them every four hours.  This was a mistake as they did become less effective, and also eventually my stomach couldn’t take the paracetamol – and throwing up when you have just donated a kidney is incredibly painful.

I went to see the GP after the op because I just couldn’t get any sleep. I would prop myself on my left side with pillows in front and behind me so that I wouldn’t roll onto my bad side – but after a few hours, when the paracetamol had worn off and my muscles became stiffer, I would wake up and it would take me ages to get back to sleep.  It would take twenty minutes for the painkillers to kick in and by then I was really wired.  My GP (a lot less stingy with drugs) prescribed cocodamol, valium (take one in the evening with a glass of wine like me, she recommended), and hallelujah! dihydrocodeine. 

What I did then was to use the cocodamol whenever the pain got too bad in the day, effectively taking one dose a day, usually mid afternoon – and then taking just one dihydrocodeine (I was allowed two) at night – which conked me right out and I was able to get a whole eight hours sleep!  I only took one, not because I was planning to take a second one later (a very bad idea for your body), but because if I got too used to it or I was having a really bad night I could up the dosage.  There’s nothing so disempowering as having taken the maximum dosage of a painkiller, and knowing you can’t do anything more but wait for the next dose.

The valium was for whenever I needed it – even if I had a headache or period pain (fantastic for both), and it’s fabulous stuff because it doesn’t take the pain away, but it makes you not care, because you just feel detached!  So you do become a lot less worried about any pain you may be having overall.

Ibuprofen is also worth taking for period pain – the renal doctors and nurses will tell you not to take ibuprofen, but my regular GP told me to ignore them because, and I didn’t know this, it reduces bleeding so it doesn’t just help period pain, but also the underlying cause.

Drugs will only help you so far, but sometimes it’s far enough, and if you also use them with other pain management methods they can give, if nothing else, a good night’s sleep; which is often the best medicine.

(They can also give you constipation if they are morphine based – so careful with them).

Another trick I have learned, which I use for migraines now, but which would have been useful if I had known about it, is the power of suggestion.  I’ve had a spate of migraines lately and I feel like the tablets I take (Migraleve) are not doing as much as they used to – so I take the tablets and, as I’m laying there, waiting for them to kick in, I tell myself “Wow I’m so stoned I’m going to pass out”.  Okay it may have been because I was watching “Ray” but it really worked.  So perhaps rather than taking the tablets and lying there thinking “Are they working yet?  How’s the pain?” you think “wow – these are some strong drugs – I can’t stay awake” – go on give it a try, can’t hurt.

I read somewhere that students given either a sedative or stimulant react to what they have been told the pill is, rather than to what it is.  I guess it’s because the mind is really much more powerful than the body, and by using this type of self hypnosis, you can strive towards Buddhist monk type pain management.

Oh yes, and a word of advice about taking pills – be kind to your stomach.  Always try and take any medication with food (even if it doesn’t say it on the packet), because you are likely to be taking quite a lot over a period of time.  I found it a very good idea to keep a biscuit tin by the bed, so if I had to take pills at night I could take a couple of biscuits with them.  It really does help.

There is another piece of advice I feel I should add, but I don’t think you’re really going to need it.  When you are being prescribed pain medication doctors are often concerned that you may become addicted, especially to drugs like valium, the reason being that they’re very nice (especially valium).  I suffered from depression before the operation, and I was really annoyed that I had never gone to my doctor and asked for an anti-depressant before, because honestly, they’re great.  But anti-depressants are best used when you are seriously depressed – to get you out of bed and fit to take more lasting measures, like therapy or regular exercise, they are not a permanent fix. 

Likewise you can’t carry on taking other pain medication at the same level, you have to reduce it and not depend upon it, or you will take more, it will become less effective and you will end up with a serious problem. 

Having said all of this, any kind of drug addiction will mess with your liver and kidney (notice the singular!), and once you have spent even one night in a ward of people having kidney dialysis or transplants because their internal organs no longer function I seriously doubt that you would ever let yourself develop a drug addiction.